Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-19T10:41:54.927Z Has data issue: false hasContentIssue false
  • English
  • Français

Health technology assessment: A comprehensive framework for evidence-based recommendations in Ontario

Published online by Cambridge University Press:  15 April 2009

Ana P. Johnson ,
Nancy J. Sikich ,
Gerald Evans ,
William Evans ,
Mita Giacomini ,
Murray Glendining ,
Murray Krahn ,
Les Levin ,
Paul Oh  and
Charmaine Perera
Ana P. Johnson
Affiliation:
Queen's University
Nancy J. Sikich
Affiliation:
Ministry of Health and Long Term Care
Gerald Evans
Affiliation:
Queen's University and Kingston General Hospital
William Evans
Affiliation:
Hamilton Health Sciences and McMaster University
Mita Giacomini
Affiliation:
McMaster University
Murray Glendining
Affiliation:
Hamilton Health Sciences
Murray Krahn
Affiliation:
University of Toronto and Toronto General Hospital
Les Levin
Affiliation:
Ministry of Health and Long Term Care and University of Toronto
Paul Oh
Affiliation:
University of Toronto
Charmaine Perera
Affiliation:
Ministry of Education
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This study describes the development of a framework for health technology decisions, for Ontario Health Technology Advisory Committee (OHTAC) in Ontario, Canada.

Methods: OHTAC convened a “Decision Determinants Sub-Committee” in January 2007, which undertook a systematic literature review and conducted key informant interviews to develop an explicit decision-making framework.

Results: The “Decision Determinants Sub-Committee” offered recommendations about decision criteria, and the process by which decisions are made. Decision criteria include (i) overall clinical benefit, (ii) consistency with societal and ethical values, (iii) value for money, and (iv) feasibility of adoption into the health system. The decision process should be transparent and fair and should use a deliberative process in delivering recommendations.

Conclusions: This methodology is currently being pilot tested in a live environment: OHTAC. It will be evaluated and revised according to its feasibility, acceptability, and perceived usefulness.

Keywords

Health technology assessmentHealth technology policy analysisOntario health technology advisory committeeMedical advisory secretariatPrioritization
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 2 , April 2009 , pp. 141 - 150
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Aaron, HJ. Serious and unstable condition. Washington DC: The Brookings Institution; 1991.Google Scholar
2. Bodenheimer, T. High and rising health care costs. Part 2: Technologic innovation. Ann Inten Med. 2005;142:932–937.CrossRefGoogle ScholarPubMed
3. Borowski, HZ, Brehaut, J, Hailey, D. Linking evidence from health technology assessments to policy and decision making: The Alberta model. Int J Technol Assess Health Care. 2007;23:155–161.CrossRefGoogle ScholarPubMed
4. Chernew, ME, Hirth, RA, Sonnad, SS, Rrmann, R, Fendrick, AM. Managed care, medical technology, and health care cost growth: A review of the evidence. Med Care Res Rev. 1998;55:259–288.CrossRefGoogle ScholarPubMed
5. Culyer, AJ. NICE's use of cost-effectiveness as an exemplar of a deliberative process. Health Econ Policy Law. 2006;1:299–318.CrossRefGoogle ScholarPubMed
6. Daniels, N, Sabin, JE. Accountability for reasonableness. In: Daniels, N, Sabin, JE, eds. Setting limits fairly: Can we learn to share medical resources. New York: Oxford University Press; 2002:43–66.CrossRefGoogle Scholar
7. Daniels, N, Sabin, JE. Accountability for reasonableness: An Update. BMJ. 2008;337:a1850.CrossRefGoogle ScholarPubMed
8. Erickson, LJ, De Wals, P, Farand, L. An analytical framework for immunization programs in Canada. Vaccine. 2005;23:2470–2476.CrossRefGoogle ScholarPubMed
9. Fuchs, VR, Sox, HC Jr. Physicians' views of the relative importance of thirty medical innovations. Health Aff (Milwood). 2001;20:30–42.CrossRefGoogle ScholarPubMed
10. Garcia-Altes, A, Ondategui-Parra, S, Neumann, PJ. Cross-national comparison of technology assessment processes. Int J Technol Assess Health Care. 2004;20:300–310.CrossRefGoogle ScholarPubMed
11. Gelijins, A, Rosenberg, N. The dynamics of technological change in medicine. Health Aff (Milwood). 1994;13:28–46.CrossRefGoogle Scholar
12. Giacomini, M. One of these things is not like the others: The idea of precedence in health technology assessment and coverage decisions. Milbank Q. 2005;83:193–223.CrossRefGoogle Scholar
13. Giacomini, M. How good is good enough? Standards in policy decisions to cover new health technologies. Healthc Policy. 2007;3:91–101.Google ScholarPubMed
14. Johnson-Masotti, AP, Eva, K. A Decision-making framework for the prioritization of health technologies. In: Beach, CM, Chaykowski, S, Shortt, S, St.-Hilaire, F, Sweetman, A, eds. Health services restructuring in Canada: New evidence and new directions. Kingston: John Deutsch Institute, Queen's University; 2006:59–81.Google Scholar
15. Lehoux, P, Williams-Jones, B. Mapping the integration of social and ethical issues in health technology assessment. Int J Technol Assess Health Care. 2007;23:9–16.CrossRefGoogle ScholarPubMed
16. Levin, L, Goeree, R, Sikich, N et al., Establishing a comprehensive continuum from an evidentiary base to policy development for health technologies: The Ontario experience. Int J Technol Assess Health Care. 2007;23:299–309.CrossRefGoogle ScholarPubMed
17. National Institute for Clinical Excellence TAT. Parallel sessions: NICE work. Technology appraisal guidance: An overview. J Clin Excell. 2002;4:350–351.Google Scholar
18. Neumann, PJ, Palmer, MS, Daniels, N et al. , A strategic plan for integrating cost-effectiveness analysis into the US healthcare system. Am J Manag Care. 2008;14:185–188.Google ScholarPubMed
19. Newhouse, JP. An iconoclastic view of health cost containment. Health Aff (Milwood). 1993;14:185–188.Google Scholar
20. Noorani, HZ, Husereau, DR, Boudreau, R, Skidmore, B. Priority setting for health technology assessments: A systematic review of current practical approaches. Int J Technol Assess Health Care. 2007;23:310–315.CrossRefGoogle ScholarPubMed
21. PausJenssen, AM, Singer, PA, Detsdu, AS. Ontario's formulary committee: How recommendations are made. Pharmacoeconomics. 2003;21:285–294.CrossRefGoogle Scholar
22. Rawlins, MD. NICE work – providing guidance to the British National Health Service. N Engl J Med. 2004;351:1383–1385.CrossRefGoogle Scholar
23. Royle, P, Waugh, N. Literature searching for clinical and cost-effectiveness studies used in health technology assessment reports carried out for the National Institutes for Clinical Excellence appraisal system. Health Technol Assess. 2003;7 (iii, ix–x):1–51.CrossRefGoogle ScholarPubMed
24. Sackett, DL, Rosenberg, WMC, Gray, JAM, Haynes, RB, Richardson, WS. Evidence based medicine: What it is and what it isn't. BMJ. 1996;312:71–72.CrossRefGoogle ScholarPubMed
25. Visalakshi, S, Mohan, S. Evaluation of biotechnology-based healthcare products for prioritization in Indian context. Int J Technol Assess Health Care. 2002;18:718–227.Google ScholarPubMed
Supplementary material: File

Johnson supplementary material

Supplementary tables and figures

Download Johnson supplementary material(File)
File 117.8 KB